Effects of alcohol consumption and accompanying diet on metabolic responseto arginine in chronic alcoholics

Objective: To evaluate, in chronic alcoholics, the effects of accompanying diet on the release of insulin (IRI) and glucagon (IRG) and on the hepatic glucose production. Method: We evaluated variations of the response to the infusion of arginine into 16 male and 8 female chronic alcoholics divided i nto three groups of eight subjects each before and after three weeks of tre atment with: (1) an isocaloric diet plus 200 g/day of ethanol; (2) an hypoc aloric diet without alcohol (17.5 kcal/kg/day); and (3) an isocaloric diet (35 kcal/kg/day). Statistical evaluation was done by Kruskall-Wallis ANOVA and by Wilcoxon matched-pairs signed rank test. Results: After isocaloric d iet plus ethanol both IRI/IRG ratios and plasma glucose during arginine tes ting remained unmodified; after the hypocaloric diet IRI/IRG remained un-mo dified and the arginine-induced plasma glucose rise was slightly but signif icantly reduced; after the isocaloric diet there was a strong decrease of t he arginine-induced plasma glucose rise because of a significant increase i n the insulin/glucagon ratio. Conclusions: In chronic alcoholics the replac ement of the usual hypocaloric diet with an isocaloric one while maintainin g alcohol consumption does not modify the metabolic response to arginine ad ministration; the hypocaloric diet without alcohol increases insulin and gl ucagon release and slightly decreases liver glycogenolysis; the replacement of the usual hypocaloric diet with an isocaloric one together with alcohol withdrawal stimulates insulin, inhibits glucagon release and lowers glycog enolysis much more than observed with hypocaloric diet alone.